Difference between Mediclaim and Health Insurance

Difference between Mediclaim and Health Insurance

Difference between Mediclaim and Health Insurance

Difference between Mediclaim and Health Insurance Difference between Mediclaim and Health Insurance | difference between mediclaim and health insurance

Health is an important aspect of life. Staying in good health is all the more important. Along with practicing healthy lifestyle it’s also important to have financial protection against health contingencies. Considering the rise in lifestyle diseases and skyrocketing cost of healthcare, it has become imperative to buy health insurance. When it comes to purchasing health insurance policy, people often get confused between health insurance policies and mediclaim policy. People use these two words interchangeably thinking mediclaim is same as that of health insurance, which is not the case. Though both the products come with similar objective, there is quite a lot of differences in their offerings. Knowing each of the product in details with understanding similarities and differences can help you secure your health better.

What is Mediclaim Policy?

Mediclaim meaning availing protection against hospitalisation expenses relating to any specific illness or an accident. Basically, the policy covers expenses incurred if the insured is admitted to seek in-patient care at the hospital for more than 24 hours. Mediclaim is a cost-effective way of availing protection against medical emergencies.

Top Features of Mediclaim Policy:

Following are the salient features of mediclaim policies:

  1. Cashless facility:
    Mediclaim policies offer cashless treatment facilities at the network hospitals where in the hospital bills are directly settled by the insurance company to the hospital without you having to incur any out-of-pocket costs
  2. Pre and post hospitalisation:
    Mediclaim policies provide pre and post hospitalisation cover for any accident/specific illness related treatments.
  3. Plan basis:
    Mediclaim policies can be purchased on individual and family floater basis
  4. Tax benefits:
    Premiums paid towards mediclaim policies qualify for tax deduction under Section 80D of the Income Tax Act, 1961

What is Health Insurance Policy?

Health insurance policies provide complete protection against any health contingencies. It is a complete package that provides comprehensive coverage against various healthcare needs including in-patient care, domiciliary hospitalisation, day care procedures and critical illness cover and many more. There is a health plan for every unique healthcare needs of people. Apart from basic coverage options, health insurance plans come with numerous attractive perks and add-on benefits to enhance the coverage. Let’s take a look at the features of health insurance policy.

Features of Health Insurance Policy

Following are some of the common features of health insurance policy:

  • Cashless facility:
    Health insurance policies come with the convenience of cashless treatment facility wherein insured can avail treatment at the network hospital of the insurance company without having to incur any out-of-pocket costs. Medical bills are settled by the insurance company directly to the hospital where treatment has been availed.
  • Pre and post hospitalisation:
    Hospital expenses for some days prior and after the hospitalisation relating to the medical condition for which the insured is hospitalised will be covered by the insurance company.
  • Day-care procedure cover:
    Most of the health insurance policies provide cover for day-care procedures which requires good financial backup. Day-care procedures covered are usually listed in the policy document.
  • Additional benefits:
    Health insurance plans come with additional benefits such as domiciliary hospitalisation cover, organ donor expenses cover, ambulance charges and daily hospitalisation cash allowance and many more.
  • Discounts:
    Health insurance plans come with various discounts such as family discount, long-term policy discounts etc which helps in reducing the premium.
  • Optional riders:
    Many health insurance policies come with additional optional riders such as critical illness cover, maternity benefits and accidental disability rider etc which helps you customise your health insurance policy based on your requirement.
  • Cover for pre-existing illnesses:
    Health insurance policies provide cover for pre-existing illnesses such as diabetes, kidney diseases etc benefits which can be availed after the specified waiting period from the date of availing the policy.
  • Plan basis:
    Health insurance plans come in various types such as individual health insurance, family floater health insurance senior citizen health insurance which can be availed based on each individual’s requirement.
  • Tax benefits:
    Health insurance plans provide tax benefits under Section 80D of the Income Tax Act, 1961 by allowing a tax deduction for the premiums paid.

Similarities and Differences between Mediclaim Policy and Health Insurance Policy

Let’s take a look at similarities and understand the difference between mediclaim and health insurance policy

Similarities:

Mediclaim policy Health Insurance policy
Cashless hospitalisation benefit All the mediclaim policies offer hospitalisation benefit which can be availed at network hospitals with cashless facility Excluding some specific plans like critical illness plans, most of the health insurance plans provide cashless hospitalisation benefit
Renewability Most of the mediclaim plans come with lifelong renewability Health insurance plans can be renewed for a lifetime
Plan basis Mediclaim policies can be availed on individual as well as family floater basis Health insurance policies can also be availed as individual and family floater plans
Online availability Most of the mediclaim policies can be purchased online Health insurance policies are also available for purchase online
Tax benefits Premiums qualify for tax deduction under Section 80D of IT Act Premiums qualify for tax deduction under Section 80D of IT Act

Differences:

Mediclaim policy Health Insurance policy  
Coverage Mediclaim policies provide specific cover which includes hospitalisation expenses for specific illness/accident Health insurance provides comprehensive coverage which includes not just hospitalisation expenses but also other covers like domiciliary hospitalisation, day-care procedures, ambulance charges and organ donor cover etc
Sum insured Mediclaim policies come with pre-decided sum insured and hospitalisation cover usually does not exceed INR 5 lakhs Health insurance policies come with extensive cover which can be enhanced (in certain plans) and sum insured can be reloaded. And the cover offered can go up to INR 100 lakhs/ 1 Cr
Hospitalisation cover Hospitalisation cover is inbuilt and necessary to avail mediclaim policy Health insurance plans like critical illness plans can be availed without hospitalisation cover. In such policies, policy benefits are paid out in lump sum on diagnosis.
Add-ons Most of the mediclaim policies do not come with an optional additional riders or add-ons Health insurance policies come with optional add-ons like accidental disability, maternity benefit, hospital cash allowance and critical illness cover etc which can be availed to customise the plan and enhance the coverage depending on the need
Flexibility Mediclaim policies offer not much flexibility when it comes to offering features and benefits Health insurance plans are more flexible that comes with various customisable features and benefits such as restoration of sum insured, enhancement of sum insured etc

How to apply for Mediclaim and Health Insurance Policy?

Both Mediclaim and health insurance plans are available for purchase online. You can log into the website of the particular insurance company and buy plans. Alternatively, you can compare various mediclaim and health insurance plans offered by many insurance companies on a side-by-side basis online on Turtlemint and buy the right plan for you in no time. Following are the simple steps to buy online on Turtlemint

  1. Log on to Turtleminthome page
  2. Choose the category of insurance as ‘health insurance’
  3. Click on ‘buy new policy’ and start filling in your profile details such as gender, marital status, date of birth, income details and contact details
  4. Once profile is complete, all types of mediclaim and health insurance plans available under health insurance category will be displayed
  5. You can compare the various plans from different insurance companies on side by side basis along with knowing the features and cost of plan
  6. Once you choose the right plan, provide the relevant details and documents
  7. Finish the purchase process by making payment. That’s it!

Documents required for buying Mediclaim and Health Insurance Policy

Following are the documents required to be submitted:

  1. Identity proof – PAN Card/Voter’s ID card/Driving license/ Passport
  2. Address proof – Aadhaar card/Driving license/Passport /Voter’s ID card/ latest telephone bills
  3. Proof of age – Birth certificate/SSLC marks card/Passport
  4. Two passport size photographs
  5. Medical reports (if policy requires you to undergo pre medical check-ups)

To conclude, knowing what each product offers helps you make a better and rational decision. Understanding the difference between mediclaim and health insurance plans can help you shop for what is most suitable for your requirement to safeguard your health adequately.

Frequently Asked Questions (FAQs)

  1. What is Critical Illness plan?

Critical illness plan is a type of health insurance plan is specially designed to provide coverage against listed critical illnesses. The policy pays out a lump sum benefit amount on diagnosis of the listed critical illnesses. Most of the policies cover critical illnesses like heart attack, cancer, stroke and kidney failures etc.

  1. What are the factors that affect health insurance premium?

There are various factors and elements taken into consideration while determining your health insurance premium. Some of the most important factors considered are your age, plan type chosen, coverage chosen, health history, locality and claim history etc

  1. What is pre-existing condition in health insurance policy?

Pre-existing condition is any illness or medical condition that existed at the time of obtaining the health insurance policy. Health insurance companies provide coverage for pre-existing conditions only after the completion of the waiting period which can vary from 12 months to 48 months.

  1. What is ‘family floater policy’?

Family floater policy is a type of mediclaim/health insurance policy that provides protection against hospitalisation expenses for the entire family in a single plan with one sum insured. The sum insured can be utilised by any insured member under the plan.

  1. What are the tax benefits offered under health insurance plans?

Following are the tax benefits offered under health insurance plans:

Description Assesse and family including parents are below 60 years age Assesse and family is below 60 years and parents are above 60 years of age Assesse and parents are above 60 years of age
Upper limit on premium paid for self, spouse and dependent children INR 25,000 INR 25,000 INR 50,000
Upper limit on premium paid for parents (dependent/non-dependent) INR 25,000 INR 50,000 INR 50,000
Total deductions allowed under Section 80D of the IT Act INR 50,000 INR 75,000 INR 1,00,000

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Courtesy Article: Supramind / October 10, 2019 mintpro.in